TYPE: Abstract
TOPIC: Cardiovascular Disease
PURPOSE: The aim of this study was to apply the Mendelian randomization (MR) design to provide an explanation for the observational association between Coronavirus Disease 2019 (COVID-19) and 3 cardiovascular and cerebrovascular diseases, including atrial fibrillation, ischemic stroke and coronary artery disease.
METHODS: Two-sample Mendelian randomization was used to determine: (1) the causal effect of COVID-19 on atrial fibrillation (55,114 case vs 482,295 control participants), coronary artery disease (34,541 case vs 261,984 control participants) and ischemic stroke (34,217 case vs 40,611 control participants); (2) the causal effect of 3 cardiovascular and cerebrovascular diseases on COVID-19. The random-effects inverse-variance weighted method was conducted for the main analyses, with a complementary analysis of the weighted median and MR-Egger approaches in four different COVID-19 databases.
RESULTS: Genetically predicted hospitalized COVID-19 was associated with ischemic stroke, with an odds ratio (OR) of 1.049 [95% confidence interval (CI) 1.003–1.098; P=0.037] in the COVID-19 Host Genetics Initiative genome-wide association study (without 23andMe) and OR of 1.041 [95% CI 1.001–1.082; P=0.044] in meta-analysis without the UKBB and 23andMe, separately. Genetically predicted coronary artery disease was associated with critical ill COVID-19, with an OR of 0.860 [95% CI 0.760–0.973; P=0.017] in the GWAS meta-analysis (without 23andMe) and OR of 0.820 [95% CI 0.722–0.931; P=0.002] in GWAS meta-analysis (without UKBB and 23andMe), separately.
CONCLUSIONS: Our findings provide direct evidence about the causal association between hospitalized COVID-19 and increased risk of ischemic stroke.
CLINICAL IMPLICATIONS: It is other mechanisms rather genetics playing an important role in heightened susceptibility to COVID-19 for patients with coronary arterial disease.
DISCLOSURE: Nothing to declare.
KEYWORD: COVID-19; Atrial fibrillation; Ischemic stroke; Coronary artery disease; Mendelian randomization